Clinicopathological Study of Lumbar Intervertebral Disc Herniation in the Aged.

We clinicopathologically examined the lumbar intervertebral herniated discs in patients aged over 50 years and compared them to young adults ranging in age from 20 to 40 years. Meterials were 14 lumbar intervertebral herniated discs in the aged, who were treated with combined lumbar spinal canal stenosis. When surgery was performed, the herniated disc was resected with the annular fiber including both edges of the posterior vertebral body in a block. Samples were then evaluated histo-pathologically. Herniated discs in the elderly revealed both fresh and old histological reactions. The fresh histological reactions, suggesting present disc herniation, included inflammatory infiltration and capillary proliferation of the rupture site of the annular fiber and posterior longitudinal ligament and around the herniated nucleus pulposus. The old histological reaction, which suggested past disc herniation, did not show any inflammatory reaction and often contained hyalinized fibrous tissue around the herniated nucleus pulposus. Based on the accumulation of lumbar intervertebral disc injury, we concluded that disc herniation combined with degenerative lumbar spinal canal stenosis occurred in these patients.